The significance of multicultural counseling competence (MCC) has been increasingly recognized in the literature on mental health. Cultural diversification in the United States has prompted greater research in specialized mental health needs among diverse populations. However, despite the specialized mental health needs, diverse cultural groups have faced challenges in finding multiculturally competent mental health services. Accordingly, mental health professions have placed a greater emphasis on the development of therapists' MCC through the training and education, but also made ongoing efforts to integrate MCC into evidenced-based treatment. However, the mental health professions have faced difficulty in exploring evidence for the validity of MCC in therapy, due to a measurement concern regarding MCC. Specifically, such measurement concern in the MCC literature is involved with the fact that there has not existed a client-rated instrument designed to measure therapists' actual MCC performance (i.e., multicultural competent behaviors) in therapeutic process. Therefore, the present study aimed to develop the Client Assessment of Multicultural Competent Behavior (CAMCB) and examine its psychometric properties with a sample of clients. With a correlational research design, the present study involved two phases (Phase I and II) with a sample of diverse clients to inform the development and validation investigation of the CAMCB. Exploratory factor analysis (EFA; n = 280) with the initial pool of 30 items resulted in a three-factor, 23-item CAMCB model. Subsequently, confirmatory factor analysis (CFA; n = 282) was performed to cross-verify the three-factor, 23-item structure of the CAMCB (as identified from EFA) and accumulate evidence of its psychometric properties. CFA resulted in a final three-factor, 19-item CAMCB model with an acceptable model fit. The final CAMCB was found to have good internal consistency reliability and initial evidence for convergent validity with the current data. Lastly, results from a multivariate analysis of variance (MANOVA) and one-way analysis of variance (ANOVA) indicated small but significant difference in the CAMCB total or subscale scores by some subgroups (e.g., race, gender, religion). Discussion of results, limitations of the present study, recommendations for future research, and implications for mental health professionals, researchers, and educators are provided.


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Graduation Date





Shillingford-Butler, Ann


Doctor of Philosophy (Ph.D.)


College of Community Innovation and Education


School of Teacher Education

Degree Program

Education; Counselor Education









Release Date


Length of Campus-only Access

1 year

Access Status

Doctoral Dissertation (Open Access)